Feature: Desperation, money drive patients abroad

Among the excited shopaholics and selfie-takers among China's outbound travelers is another group - more serious and usually carrying their medical records.

They are going for medical treatment abroad and many are traveling for a last chance at life.

Xue Lingling is one of the lucky ones.

When Xue's face began swelling up, she visited numerous doctors in different hospitals, before a reputed hospital in Shanghai finally diagnosed her condition as non-Hodgkin lymphoma. Her immediate and constant question was: how long will I live?

The answers were ambiguous and pessimistic. Doctors in China told her that she might have to undergo an operation that had a low success rate and would scar her face.

She refused to accept this and decided to go to the United States for treatment.

In December 2014, Xue travelled to the Dana-Farber Cancer Institute in Boston, Massachusetts. After a high-precision biopsy, she was told that there were several types of non-Hodgkin lymphoma and that treatment for the type she was suffering from had a higher success rate because the cancer cells were slow growing.

Xue underwent precision chemotherapy and the doctor said the possibility of a relapse in the next 10 years was less than 10 percent.

Xue was assisted in finding treatment by Saint Lucia Consulting. Its services included translating her medical records, making an appointment with the hospital, and providing companionship and language assistance during the treatment.

Established in 2011, Saint Lucia is one of China's largest consultancies for cross-border medical services, and has contractual long-term partnerships with dozens of the world's best hospitals in the United States, Germany, Britain and other countries.

Saint Lucia Consulting received only two cases in its first year, but now helps more than 500 Chinese get medical treatment abroad each year. CEO and founder Cai Qiang says the growth rate is beyond his expectations.

"Traveling abroad, studying overseas and even immigration are now common for Chinese, but when it comes to seeking medical treatment abroad, they are not convinced. Healthcare is very technical for ordinary people, and even wealthy patients are unaware of the option of seeking treatment abroad," Cai says.

With the globalization of healthcare and growing numbers of Chinese celebrities such as Olympic athlete Liu Xiang seeking treatment abroad, more Chinese are realizing that they can also seek world-class medical care.

According to China's National Cancer Prevention and Research Center, the five-year survival rate of Chinese patients is around 30 percent, half that of cancer patients in the United States. Besides lower standards of care, patients' complaints about Chinese hospitals include long waiting times, lengthy diagnoses and impatient doctors. The advanced medical technologies and friendlier medical services in developed countries appeal to the Chinese.

"As there are family doctors and an advanced hierarchical medical system in the US, only those with rare diseases are sent to world-renowned medical institutions, which are not overloaded with people like Chinese hospitals," Cai says.

Xue Lingling was impressed by the thoughtful and careful treatment. During her chemotherapy, the doctor detailed the unexpected side-effects and asked her to express her feelings freely. In contrast, when she was doing a magnetic resonance imaging scan in a hospital in China, she was "fixed on the bed with fear". The doctor told her to be motionless, without giving any explanation.

"I was very surprised that the US doctor answered my questions with great patience. If that happened in China, the doctor would have a long queue outside the door," Xue says.

In Cai Qiang's view, the top priority is choosing the right doctor and hospital, which requires good knowledge of the medical resources around the world.

When a patient needs a heart stent implant, Cai says, Saint Lucia recommends the Royal Brompton Hospital in the UK, which is famous for dissolvable stents; when a patient with brain tumor needs radiotherapy, it recommends Massachusetts General Hospital in the US, which boasts advanced proton beam therapy.

Many foreign medical institutes are reaching out to the Chinese market. The University of Texas MD Anderson Cancer Center (MDACC), a top-ranking cancer research institute and hospital in the United States is one of them.

Martha Coleman, administrative director of MDACC's International Center, says MDACC has received more than 500 Chinese patients in the last five years. She has seen a 40 percent increase each year for the past two years and the number continues to grow.

Coleman welcomes Chinese patients and recommends that patients be better prepared to adjust to the cultural and medical differences.

"We have adopted several measures to facilitate Chinese patients. The international center website is translated into Chinese and we have added another Chinese international patient assistant to our staff. We are also working on an international patient video in Chinese for patients...," Coleman says.

Sometimes the patients' families want the doctor to keep a cancer diagnosis secret from the patient, says Zhuang Meiling, an international patient assistant at MDACC.

"But we find it hard to accommodate that request and describe the treatment needed. The oncology treatments usually cost a lot of money and some patients' expectations are not realistic. We hope the patients are well aware that cancer is a natural process and even MDACC cannot always cure it."

The Mayo Clinic set up a referral office in China in August, through which Chinese patients can get a second opinion or make a quick appointment to see if the doctor suggests further treatment in the United States.

Cai considers treatment abroad a niche market and only for a tiny proportion of the super rich. It offers a possible solution, but is not suitable for every patient.

"First and foremost, the patient must be able to afford it; then they should be fit enough to travel a long way. They should adjust their expectations and be aware that there is no guarantee of a cure," Cai says.

A rising number of consulting firms have expanded ambitiously to meet the growing market, but some exaggerate the treatment effects and charge a lot. Some firms are less competent in medical records preparation, which can delay treatment.

"Treatment abroad is still in its infancy in China. With more firms joining, there is a need for service standards or regulations. The patients' rights need better protection," Cai says. Endit